Medicaid Alert: New York State Budget and its Impact on Nursing Home Medicaid Eligibility

On April 9, 2022, Governor Kathy Hochul signed the annual state budget and addressed many important issues facing older adults.  The budget expands Medicaid benefits for people 65 and over, as well as benefits for the disabled. The state budget raised the permissible income and resources thresholds, which will be made effective on January 1, 2023, allowing many more older New Yorkers to qualify for institutional Medicaid benefits than ever before.

Expansion of Medicaid

INCOME: Currently, a single individual cannot have more than $934 in monthly income in order to qualify for Medicaid benefits (or $1,367 each for married couples). Effective January 1, 2023, the income threshold will increase to $1,563 each month for single applicants (or $2,106 each month for married couples).  Individuals or couples with higher income levels may continue to “spend down” their excess income on medical bills or utilize pooled income trusts to qualify for benefits.

RESOURCES: Currently, a single individual cannot have more than $16,800 in total assets in order to qualify for Medicaid benefits ($24,600 for married couples).  Effective January 1, 2023, the new asset limit will be $28,134 ($37,908 for married couples).  Even though the proposed state budget initially called for a complete elimination of the Medicaid resource test, this was not incorporated into the final state budget.

What does this mean for nursing homes in New York?  Based on the substantial increases in the Medicaid income and resources thresholds, we anticipate that more older New Yorkers will qualify for institutional Medicaid benefits than ever before. This will likely mean that facilities will have fewer “private pay” residents, and more residents who are recipients of Medicaid benefits.

In light of the impact this may have on nursing homes financially, it is more important than ever to preserve your bottom line!  The experienced and skilled attorneys at Cona Elder Law can assist you in securing Medicaid benefits for residents under these “new rules” and ensuring that no private pay or Medicaid reimbursement dollars are left on the table.